Standard Operating Procedure
|
|
- Patience French
- 5 years ago
- Views:
Transcription
1 Procedure to ensure Safe and Appropriate Valproate Prescribing in Female Patients Standard Operating Procedure Revision Chronology Version Number Effective Date Reason for Change Version 1.0 November 2017 Version: Author: Designation: Responsible Director: Target Audience: Approved By: Approval Date: November 2017 Review Date: November 2019 V1 Heather Beadle and Lilian Baxendale Clinical Governance Pharmacist Medical Director All qualified healthcare professionals working within CWPT Drug and Therapeutics Groups
2 CONTENTS Standard Operating Procedure Title Procedure to ensure Safe and Appropriate Valproate Prescribing in Female Patients SOP Number 1 Version 1 Effective Date November 2017 Review Date November 2019 Superseded Version Number & Date (if applicable) Author N/A Heather Beadle and Lilian Baxenadale CONTENT: 1. Purpose 2. Background 3. Procedure 4. Appendices Responsible Personnel Name Date Medicines Management Team November 2017 All prescribers and other qualified healthcare professionals working November 2017 within CWPT
3 1. PURPOSE This SOP aims to ensure that valproate is appropriately prescribed in female patients in line with current MHRA Guidance. Valproate should not routinely be prescribed to: female children, female adolescents, women of childbearing potential or pregnant women unless there is a positive risk benefit balance and the patient is aware of and accepts that risk. 2. BACKGROUND In January 2015 the MHRA published new guidance regarding the use of sodium valproate in women of child bearing age. Following a Europe-wide review, it was concluded that children exposed in utero to valproate are at a high risk of serious developmental disorders (in up to 30-40% of cases) and/or congenital malformations (in approximately 10% of cases). A Drug Safety Update was issued by the MHRA advising that valproate, should not be prescribed to female children, female adolescents, women of childbearing potential or pregnant women unless other treatments are ineffective or not tolerated. Despite this, a survey of women taking valproate in 2016 found that 20% were not aware of the risks of valproate in pregnancy and <20% had received any of the educational materials. Subsequently, a Patient Safety Alert (PSA) has been issued, requiring organisations to undertake a systematic identification of girls and women who are taking valproate and to ensure that the resources contained within the toolkit are used to support them to make an informed choice. MHRA guidance states that valproate treatment must be started and supervised by a specialist experienced in managing epilepsy or bipolar disorder. The potential benefits of prescribing valproate MUST be carefully balanced against the risks when prescribing valproate for the first time, at routine treatment reviews, when a female child reaches puberty and when a woman plans pregnancy or becomes pregnant. The Medicines and Healthcare products Regulatory Agency (MHRA) have developed Communication materials Valproate toolkit to support discussion of these risks with women of childbearing potential and girls who take valproate. The MHRA toolkit aims to help ensure that female patients are better informed about the risks of taking valproate during pregnancy. The materials should be used to support discussion of the risks. CWPT Healthcare Professionals may come into contact with patients who are taking valproate which has been initiated within CWPT (e.g. mental health, learning disability, children s services) or external to CWPT (e.g. neurologists). 3. PROCEDURE This SOP applies to the prescribing of all formulations of valproate, including: sodium valproate, valproate semisodium and valproic acid (thereafter referred to as valproate). It is applicable to all indications including prescribing in: epilepsy, manic episodes associated with bipolar disorder and migraine prophylaxis.
4 There may be patients who lack capacity to understand the valproate guidance due to a learning disability. For these patients, documentation should be made of the capacity assessment and discussion of Valproate risks with carer so that a Best Interest decision can be made regarding continuing or changing the treatment. ALL female patients MUST be informed of, and understand: The risks associated with valproate during pregnancy The need to use effective contraception The need for regular review of treatment The need to rapidly consult if a pregnancy is planned or is confirmed To achieve this Healthcare Professionals have the following responsibilities: 3.1 Treatment initiated by CWPT services: Prescribers: New Valproate patients (See algorithm 1): The Prescriber must use the toolkit to support discussion of the risks of valproate prescribing with female patients The Prescriber must supply the patient/carer with a copy of the Patient s Guide The Prescriber must discuss the risks with the patient and ensure that the patient fully understands the necessary information If the decision is made to start valproate therapy: The completed consultation checklist must be added to the patient s medical records as a permanent record of the discussion A flag ( valproate- discussion had ) must be added to carenotes to indicate that the patient is prescribed valproate and that a discussion has been had regarding risk of treatment Existing Valproate Patients (See algorithm 1): A prescriber may also identify female patients who are already prescribed valproate. When this happens the prescriber must clarify if a review has already taken place e.g. by checking on carenotes (i.e. valproate- discussion had is flagged). The above procedure (3.1.2) for new patients must be followed where this has not occurred. At each appointment the prescriber should re-iterate the message about the risks with valproate. The discussion should be documented, noting if the valproate is to be continued Patients transferred to GP care: Where a patient is started on valproate, or identified as being on valproate, information about the discussion of risks, where the person has been referred for contraception, etc. should be shared with the GP.
5 Pharmacists: Pharmacists should supply a copy of the Patient Card when valproate is dispensed. This information should be discussed with the patient to ensure that the message is understood and to clarify if there are any questions All Other Healthcare Professionals (See algorithm 3): If a Healthcare Professional identifies a female patient prescribed valproate they should check if the patient has had a discussion with their prescriber about taking valproate. (The Healthcare professional may also be able to check the entry on Carenotes to identify if there is a flag to indicate that the valproate prescribing has been reviewed and the patient has been supplied with the appropriate information). If this has not happened the professional should refer the patient to the CWPT prescriber for review (if still open to that service; if not, to the GP) and create an alert on carenotes ( valproate- no discussion) if their service uses carenotes. If the service does not use carenotes, a record of the referral should be made in the patient notes. 4.1 Treatment initiated external to CWPT (e.g. by neurologist) 4.1. Prescribers (See algorithm 2) A prescriber may identify female patients who are already prescribed valproate which has been initiated external to CWPT. Unless they are prescribing the valproate they are not responsible for reviewing the appropriateness of the treatment, but are responsible for checking that the patient is aware of the risk of treatment The prescriber must clarify if a discussion has already taken place with the patient about the risks of treatment e.g. by checking with the patient or on carenotes ( valproate- discussion had is flagged) If the discussion has not already taken place the prescriber should discuss the risks with the patient using the MHRA toolkit. The discussion should be documented and a flag ( valproate discussion had ) created on carenotes (if the service uses carenotes). The prescriber will not be in a position to evaluate the risk:benefit of treatment with valproate. If the patient is considering not taking valproate due to the risks, she should be referred back to the service that initiated the treatment/gp If the discussion has already taken place, the prescriber should reiterate the message about the risks with valproate at each appointment Pharmacists Pharmacists should supply a copy of the Patient Card when valproate is dispensed. This information should be discussed with the patient to ensure that the message is understood and to clarify if there are any questions All Other Healthcare Professionals (See algorithm 4) If a Healthcare Professional identifies a female patient prescribed valproate they should check if the patient has had a discussion about taking valproate with their
6 prescriber. (The Healthcare professional may also be able to check the entry on Carenotes to identify if there is a flag to indicate that the valproate prescribing has been reviewed and the patient has been supplied with the appropriate information). If this has not happened the professional should suggest that the patient contacts the initiating service (if still open to that service) or GP for review and create an alert on carenotes ( valproate- no discussion) if their service uses carenotes. If the service does not use carenotes, a record of the discussion should be made in the patient notes.
7 4. APPENDICES Important Information for Healthcare Professionals on the Risks of Valproate in Female Patients Treatment with valproate for female patients: Checklist for patients and prescribers Valproate Patient Guide Key Facts Valproate and Pregnancy References: Resources to support the safety of girls and women who are being treated with valproate: NHS/PSA/RE/2017/002 6 April 2017
8 Algorithm 1 - CWPT Prescriber responsibilities for Patients initiated on valproate within CWPT CWPT Prescriber New Patient Existing Patient Use Toolkit to support discussion of the risks of valproate prescribing Enquire whether a discussion has already taken place check for flag in Carenotes Decision made to start valproate prescribing despite risks No Yes Issue MHRA Booklet Use toolkit to support documentation of risk Reiterate risk (Have discussion and document) Create flag on Carenotes to say Valproate discussion had Ensure that the flag on Carenotes says Valproatediscussion had Scan and add the completed consultation checklist to Carenotes If Carenotes is not available then document the discussion and outcomes in the patient s notes Prescriber Responsibilities: Appropriate indication Check Patient is aware of risks
9 Algorithm 2 - CWPT Prescriber responsibilities for Patients initiated on valproate external to CWPT CWPT Prescriber Check whether the patient is aware of the risks of valproate by asking them/checking flag status on Carenotes Patient aware Patient not aware Discuss risks again Use MHRA toolkit to discuss risks Patient wishes to continue on valproate Patient uncertain or doesn t want to continue on valproate Patient wishes to continue on valproate Flag Valproate-discussion had on Carenotes Refer to initiating service (if still open to patient) or GP to review. Advise patient not to stop valproate until after this review Flag Valproate-discussion had on Carenotes If Carenotes is not available, document the discussion and outcomes in the patient notes. Prescriber Responsibilities: Check Patient is aware of risks
10 Algorithm 3 - CWPT Healthcare professional responsibilities for Patients initiated on valproate within CWPT If Carenotes is not available, document the discussion and outcomes in the patient notes. Other Healthcare Professional Patient Currently taking valproate Check with patient whether she has had a discussion with prescriber about the risks with valproate Patient says Yes Patient says No Ensure patient requires no further information/support; refer to prescriber if necessary Refer patient to the initiating CWPT prescriber/service for review. (Refer back to GP if not open to service) Create alert on Carenotes Valproatediscussion not had If Carenotes is not available then document the outcomes in the patient s notes
11 Algorithm 4 - CWPT Healthcare responsibilities for Patients initiated on valproate external to CWPT Other Healthcare Professional Patient Currently taking valproate Check with patient whether she has had a discussion with prescriber about the risks with valproate Patient says Yes Patient says No Ensure patient requires no further information/support; refer to prescriber if necessary Suggest patient contacts GP/initiating prescriber or service for discussion Create alert on Carenotes Valproatediscussion not had If Carenotes is not available then document the outcomes in the patient s notes
Annex III. Amendments to relevant sections of the Product Information
Annex III Amendments to relevant sections of the Product Information Note: These amendments to the relevant sections of the Summary of Product Characteristics and package leaflet are the outcome of the
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest
More informationAnnex III. Amendments to relevant sections of the summary of product characteristics and package leaflets
Annex III Amendments to relevant sections of the summary of product characteristics and package leaflets Note: These amendments to the relevant sections of the Summary of Product Characteristics and package
More informationInformation on the risks of Valproate (Epilim) use in girls (of any age), women of childbearing potential and pregnant women.
CONTAINS NEW INFORMATION GUIDE FOR HEALTHCARE PROFESSIONALS Information on the risks of Valproate (Epilim) use in girls (of any age), women of childbearing potential and pregnant women. Read this booklet
More informationDrug Safety Communication
PPR/W/012/16 28 th June 2016 Drug Safety Communication Valproate Related Medicines (Depakine): Risk of Abnormal Pregnancy Outcomes NHRA wishes to bring your attention to the high risk of abnormal pregnancy
More informationFormulary and Prescribing Guidelines
Formulary and Prescribing Guidelines SECTION 3: TREATMENT OF BIPOLAR AFFECTIVE DISORDER This section provides information regarding the pharmacological management of Bipolar affective disorder in secondary
More informationShared Care Guideline. The Management of Epilepsies in Children
THE SOUTH YORKSHIRE & BASSETLAW Shared Care Guideline For The Management of Epilepsies in Children Shared care guideline developed by: Sheffield Children's NHS Foundation Trust; Dr P Baxter Consultant
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
Recognising and managing bipolar disorder in adults in primary care bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are
More informationPLEASE READ Important Patient Safety Information Approved by HPRA
PLEASE READ Important Patient Safety Information Approved by HPRA Valproate (Epilim ): NEW restrictions on use PREGNANCY PREVENTION PROGRAMME to be put in place. 16 April 2018 Dear Healthcare professional,
More informationBenefits and risks of taking antiepileptic medicine for females Information for healthcare professionals
Benefits and risks of taking antiepileptic medicine for females Information for healthcare professionals 2 Benefits and risks of taking antiepileptic medicine for females 3 This booklet provides information
More informationPLEASE READ Important Patient Safety Information Approved by HPRA
PLEASE READ Important Patient Safety Information Approved by HPRA Valproate (Epilim ): NEW restrictions on use PREGNANCY PREVENTION PROGRAMME to be put in place. 16 April 2018 Dear Pharmacist, This letter
More informationValproate. (Epilim, Depakote, Convulex, Episenta, Epival, Kentlim, Orlept, Sodium Valproate, Syonell & Valpal)
CONTAINS NEW INFORMATION Valproate (Epilim, Depakote, Convulex, Episenta, Epival, Kentlim, Orlept, Sodium Valproate, Syonell & Valpal) Patient Guide: What women and girls need to know about valproate This
More informationSurveillance report Published: 12 April 2018 nice.org.uk
Surveillance report 2018 Epilepsies: diagnosis and management (2012) NICE guideline CG137 Surveillance report Published: 12 April 2018 nice.org.uk NICE 2018. All rights reserved. Subject to Notice of rights
More informationUpdated advice for nurses who care for patients with epilepsy
NICE BULLETIN Updated advice for nurses who care for patients with epilepsy NICE provided the content for this booklet which is independent of any company or product advertised NICE BULLETIN Updated advice
More informationepilepsy review template
epilepsy review template Everyone with epilepsy should have a regular structured review, at least once a year. This should be either with a specialist (paediatrician or neurologist) or their GP, depending
More informationepilepsy review template
epilepsy review template Everyone with epilepsy should have a regular structured review, at least once a year. This should be either with a specialist (paediatrician or neurologist) or their GP, depending
More informationGuidance on prescribing valproate for bipolar disorder in women of child-bearing potential
Guidance on prescribing valproate for bipolar disorder in women of child-bearing potential Background Valproate is prescribed for mood stabilisation in bipolar disorder; however it is wellestablished as
More informationDrug Name: Lithium Clinical Indications: Treatment and prophylaxis of mania; bipolar disorder; augmentation therapy in treatment resistant depression
SHARED CARE PROTOCOL AND INFORMATION FOR GPS Drug Name: Lithium Clinical Indications: Treatment and prophylaxis of mania; bipolar disorder; augmentation therapy in treatment resistant depression Version:
More informationTOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER)
divalproex sodium TOP APS DRUGS - DIVALPROEX SODIUM BRAND NAME: DEPAKOTE (ER) Pharmacodynamics study of what a drug does to the body Divalproex sodium is chemically compounded from sodium valproate and
More informationPolicy for the safe use of oral methotrexate
Policy for the safe use of oral methotrexate Policy Checklist Name of Policy: Purpose of Policy: Directorate responsible for Policy Name & Title of Author: Does this meet criteria of a Policy? Staff side
More informationPATIENT GROUP DIRECTION
PATIENT GROUP DIRECTION FOR THE SUPPLY OF VARENICLINE (CHAMPIX ) TO ADULTS OVER 18 YEARS OF AGE BY COMMUNITY PHARMACISTS UNDER THE PUBLIC HEALTH SERVICE - SMOKING CESSSATION SERVICE IN NHS HIGHLAND THE
More informationA study of Standard and New Antiepileptic Drugs SANAD-II
The SANAD II project is funded by the NIHR Health Technology Assessment Programme. Hospital Logo Address NIHR code A study of Standard and New Antiepileptic Drugs SANAD-II ADULT INFORMATION SHEET www.sanad2.org.uk
More informationManagement of Epilepsy in Primary Care and the Community. Carrie Burke, Epilepsy Specialist Nurse
Management of Epilepsy in Primary Care and the Community Carrie Burke, Epilepsy Specialist Nurse Epilepsy & Seizures Epilepsy is a common neurological disorder characterised by recurring seizures (NICE,
More informationVALPROATE. (Epilim, Depakote ) Patient Information Booklet
VALPROATE (Epilim, Depakote ) Patient Information Booklet This booklet contains key information about the risks of valproate in pregnancy. This booklet is for you, if you are a girl or a woman taking any
More informationAppendix 3 Administration of Covert Medication Review Form
Appendix 3 Administration of Covert Medication Review Form Name of service user Date of birth Date review performed Is medication still necessary? If so, explain why Is covert administration still necessary?
More informationThe treatment of bipolar disorder in adults, children and adolescents
DRAFT FOR CONSULTATION The treatment of bipolar disorder in adults, children and adolescents The paragraphs in the draft are numbered for the purposes of consultation. The final version will not contain
More informationPrescribing Dilemmas. Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May
Prescribing Dilemmas Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May 2016 The four principles of medicines optimisation Aim to understand the patient s experience Evidence
More informationCLINICAL GUIDELINES FOR THE MANAGEMENT OF EPILEPSY
CLINICAL GUIDELINES FOR THE MANAGEMENT OF EPILEPSY Information for People with Seizures THE EPILEPSY RESEARCH PROGRAM OF THE ONTARIO BRAIN INSTITUTE TABLE OF CONTENTS About This Booklet... 1 What is Epilepsy?...
More informationPatient/Carer Guide. Subcutaneous injection for routine prophylaxis of bleeding episodes in patients with haemophilia A with factor VIII inhibitors
Patient/Carer Hemlibra (emicizumab) Patient/Carer Guide Hemlibra (emicizumab) Subcutaneous injection for routine prophylaxis of bleeding episodes in patients with haemophilia A with factor VIII inhibitors
More informationLincolnshire Prescribing and Clinical Effectiveness Bulletin
S Lincolnshire Prescribing and Clinical Effectiveness Bulletin Volume 12 No 10, November 2018 Optum in association with Lincolnshire Clinical Commissioning Groups, Lincolnshire Community Health Services,
More informationGuidance for naltrexone prescribing
Document level: Drug Alcohol (Trustwide) Code: DA7 Issue number: 2 Guidance for naltrexone prescribing Lead executive Authors details Type of document Target audience Document purpose Lead Clinical Director
More informationEssential Shared Care Agreement: Melatonin (Circadin, Bio-Melatonin)
Ref No: E056 Essential Shared Care Agreement: Melatonin (Circadin, Bio-Melatonin) Please complete the following details: Patient s name, address, date of birth, and either complete when the consultant
More informationrisk Does my epilepsy put me at risk?
risk Does my epilepsy put me at risk? 3 4 4 5 6 7 8 9 10 13 14 does my epilepsy put me at risk? making choices about risk getting good seizure control staying safe safety aids and equipment risk assessments
More informationCOMBINATION THERAPIES PREVENTATIVE THERAPIES BETA BLOCKERS
ACUTE THEAPIES TIPTANS TICYCLIC ANTIDEPESSANTS When starting acute treatment, healthcare professionals should warn patients about the risk of developing medication-overuse headache. ASPIIN Aspirin (900
More informationTHE SPECIALIST NURSE INTERVENTION: PROMOTING UNDERSTANDING. Marianne Peachey Epilepsy Specialist Nurse The Ipswich Hospital NHS Trust
THE SPECIALIST NURSE INTERVENTION: PROMOTING UNDERSTANDING Epilepsy Specialist Nurse The Ipswich Hospital NHS Trust NURSING Is it Art or Science? Hospital Consultants General Practitioners Hospital Nursing
More informationDr Clare Sheahan, Dr Diana Howlett (plus wider input via CCHP Autism Core group)
Clinical Guideline AUTISM DIAGNOSTIC ASSESSMENT CARE PATHWAY Autism Spectrum Health Care Pathway (0-18) FOR STAFF SETTING MAIN AUTHORS Community Paediatricians, speech and language therapists, CAMHS team
More informationProduct Name Strength Pharmaceutical Form. Valproat-Ratiopharm Chrono 300 mg. Valproat-Ratiopharm Chrono 500 mg
ANNEX I LIST OF THE NAMES, PHARMACEUTICAL FORMS, STRENGTHS OF THE MEDICINAL PRODUCTS, ROUTE OF ADMINISTRATION, MARKETING AUTHORISATION HOLDERS IN THE MEMBER STATES (EU/EEA) 1 Member State (EU/EEA) Czech
More informationE096. Essential Shared Care Agreement: Melatonin (Circadin ) in Children, adolescents and adults only with Learning Disability
E096 Essential Shared Care Agreement: Melatonin (Circadin ) in Children, adolescents and adults only with Learning Disability Please complete the following details: Patient s name, address, date of birth,
More informationDocument Details. Patient Group Direction
Document Details Title Patient Group Direction (PGD) Salbutamol Aerosol Inhaler and salbutamol Nebulised Solution Trust Ref No 1569-34313 Local Ref (optional) Main points the document Treatment of acute
More informationThese standards apply to all Professional Groups. A member of: Association of UK University Hospitals
A member of: Association of UK University Hospitals Minimum Standards for the Recording of Risk Screening, Assessment and Management Plans in Adult, Learning Disability, & Forensic Healthcare (February
More informationSIGN on the pharmacological management of migraine
GUIDELINES SIGN on the pharmacological management of migraine STEVE CHAPLIN In February 2018, the Scottish Intercollegiate Guidelines Network (SIGN) published a new guideline on the pharmacological management
More informationEpilepsy: pharmacological treatment by seizure type. Clinical audit tool. Implementing NICE guidance
Epilepsy: pharmacological treatment by seizure type Clinical audit tool Implementing NICE guidance 2012 NICE clinical guideline 137 Clinical audit tool: Epilepsy (2012) Page 1 of 25 This clinical audit
More informationPOLICY FOR THE SAFE USE OF ORAL METHOTREXATE IN SECONDARY CARE. September 2011
POLICY FOR THE SAFE USE OF ORAL METHOTREXATE IN SECONDARY CARE September 2011 WHSCT Policy for the safe use of oral methotrexate in secondary care Page 1 of 8 Policy Title Policy for the safe use of oral
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest
More informationAnnual Progress and Safety Reporting SOP for HEY-sponsored CTIMPs
R&D Department Annual Progress and Safety Reporting SOP for HEY-sponsored CTIMPs Hull and East Yorkshire Hospitals NHS Trust 2010 All Rights Reserved No part of this document may be reproduced, stored
More informationPregnancy. General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition)
Pregnancy General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition) In all women of child bearing potential Always discuss the possibility of pregnancy; half of all pregnancies are unplanned
More informationDubai Standards of Care (Migraine)
Dubai Standards of Care 2018 (Migraine) Preface Migraine is one of the most common problem dealt with in daily practice. In Dubai, the management of migraine is done through various different strategies.
More informationUsing MiCAL v18 (Medicines Information Computer Aided Learning) effectively
Using MiCAL v18 (Medicines Information Computer Aided Learning) effectively Contents 1. to MiCAL and MiDatabank... 3 2. What s in MiCAL... 3 Table 1: Case scenario titles, complexity, and clinical topic....
More informationStandard Operating Procedure: Early Intervention in Psychosis Access Times
Corporate Standard Operating Procedure: Early Intervention in Psychosis Access Times Document Control Summary Status: New Version: V1.0 Date: Author/Owner: Rob Abell, Senior Performance Development Manager
More informationSHARED CARE PROTOCOL FOR THE PRESCRIBING AND MONITORING OF MEDICINES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD)
SHARED CARE PROTOCOL FOR THE PRESCRIBING AND MONITORING OF MEDICINES FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD) 1. Introduction This protocol describes how patients prescribed medicines for ADHD
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE QUALITY AND OUTCOMES FRAMEWORK (QOF) INDICATOR DEVELOPMENT PROGRAMME QOF indicator area: Epilepsy Briefing paper Potential output: Recommendations
More informationShared Care Guideline Stiripentol use for SCN1A related and Severe Myoclonic Epilepsies in Infancy
Shared Care Guideline Stiripentol use for SCN1A related and Severe Myoclonic Epilepsies in Infancy Executive Summary 1. Indication Stiripentol is indicated for use in conjunction with clobazam and valproate
More informationDeveloped By Name Signature Date
Patient Group Direction 2156 version 2.0 Administration of Ipratropium 250mcg/ml Nebuliser Solution in Acute Asthma by Registered Practitioners employed by Torbay and South Devon NHS Foundation Date of
More informationGuidance for Pharmacists on Safe Supply of Oral Methotrexate
Guidance for Pharmacists on Safe Supply of Oral Methotrexate Pharmaceutical Society of Ireland Version 2 January 2015 Contents 1. Introduction 2 2. Methotrexate 2 3. Guidance 2 3.1 Patient Review 2 3.2
More informationBosentan Accord Prescriber s Guide. This guide provides important safety information about Bosentan Accord regarding the risk
Bosentan Accord Prescriber s Guide This guide provides important safety information about Bosentan Accord regarding the risk of liver injury and birth defects. Information is provided concerning the monitoring
More informationNPSA SAFER LITHIUM THERAPY GUIDELINES FOR NHS LANARKSHIRE
NPSA SAFER LITHIUM THERAPY GUIDELINES FOR NHS LANARKSHIRE Implementation Date Spring 2013 Review Date Spring 2016 NPSA Safer Lithium Therapy Guidelines for NHS Lanarkshire BACKGROUND On 1 st December 2009
More informationSurveillance report Published: 8 June 2017 nice.org.uk. NICE All rights reserved.
Surveillance report 2017 Antenatal and postnatal mental health: clinical management and service guidance (2014) NICE guideline CG192 Surveillance report Published: 8 June 2017 nice.org.uk NICE 2017. All
More informationAtomoxetine Effective Shared Care Agreement For Attention Deficit Hyperactivity Disorder (ADHD)
Atomoxetine Effective Shared Care Agreement For Attention Deficit Hyperactivity Disorder (ADHD) Section 1: Shared Care arrangements and responsibilities Section 1.1 Agreement to transfer of prescribing
More informationDeveloped By Name Signature Date
Patient Group Direction 2155 version 2.0 Administration / Supply of Inhaled Salbutamol in Asthma by Registered Practitioners employed by Torbay and South Devon NHS Foundation Trust Date of Introduction:
More informationMycophenolate mofetil: risks of miscarriage and birth defects. Patient guide
Mycophenolate mofetil: risks of miscarriage and birth defects Patient guide Key points to remember Mycophenolate mofetil causes birth defects and miscarriages Follow the contraceptive advice given to you
More informationImproving quality of care for epilepsy patients using a pharmacist review service
Improving quality of care for epilepsy patients using a pharmacist review service Carole Brown MSc (Clin Pharm), PIP, PwSI Epilepsy, MRPharmS A structured review process for epilepsy in primary care has
More informationEpilepsy & Pregnancy READ ONLINE
Epilepsy & Pregnancy READ ONLINE Women with epilepsy have special concerns about conception and pregnancy - medication, dosing schedules, seizure management, delivery complications. Written by mums with
More informationPROCEDURE REFERENCE NUMBER SABP/EXECUTIVE BOARD/0017/PROCEDURE15 PROCEDURE NAME MEDICINES PROCEDURE 15: METHOTREXATE
PROCEDURE REFERENCE NUMBER SABP/EXECUTIVE BOARD/0017/PROCEDURE15 PROCEDURE NAME MEDICINES PROCEDURE 15: METHOTREXATE BRIEF OUTLINE OF THIS PROCEDURE This procedure sets out the requirements for prescribing,
More informationNUMERATOR: Female patients or caregivers counseled at least once a year about how epilepsy and its treatment may affect contraception OR pregnancy
Quality ID #268 (NQF 1814): Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY
More information02/GMS/0030 ADULT EPILEPSY SERVICE CCP for General Medical and Surgical POOLE HOSPITAL NHS FOUNDATION TRUST
Service Specification No. Service Commissioner Leads 02/GMS/0030 ADULT EPILEPSY SERVICE CCP for General Medical and Surgical Provider Lead POOLE HOSPITAL NHS FOUNDATION TRUST Period 1 April 2013 to 31
More informationGuidance on Bulk Prescribing for Care Home Patients
Guidance on Bulk Prescribing for Care Home Patients Introduction Many patients in care homes taking medicines when required (PRN) can inevitably present problems for the prescriber in determining the quantity
More informationEPILEPSY SUPPORT ASSOCIATION UGANDA
INFO PAGE 2 MEDICAL MANAGEMENT OF EPILEPSY MEDICATION FOR EPILEPSY The standard modern treatment for epileptic seizures is the regular use of one or more chemical substances called anti-convulsant or anti-epileptic
More informationWhat is the lowest dose of depakote
What is the lowest dose of depakote The Borg System is 100 % What is the lowest dose of depakote Oral dosage (delayed-release divalproex (Depakote), valproic acid (Depakene), or delayed-release valproic
More informationNovel oral anticoagulant therapy (NOAC)
Haematology Department Novel oral anticoagulant therapy (NOAC) Information for patients, relatives and carers What is novel oral anticoagulant therapy? Novel oral anticoagulants, or NOACs, are drugs which
More informationHypertension Clinical case scenarios for primary care
Hypertension Clinical case scenarios for primary care Implementing NICE guidance August 2011 NICE clinical guideline 127 What this presentation covers Five clinical case scenarios, including: presentation
More informationMenopause: diagnosis and management NICE guideline NG23. Published November 2015
Menopause: diagnosis and management NICE guideline NG23 Published November 2015 1 Full title: Menopause : diagnosis and management Available at: http://www.nice.org.uk/guidance/ng23 Guideline published
More informationHealth Promotion Service Project Overview
Health Promotion Service Project Overview TITLE NATIONAL TARGETS / LOCAL PRIORITIES SCOPING Young Peoples Sexual Health Promotion Worker Every Child Matters- Reducing Teenage Pregnancy Strategy. Two national
More informationPATIENT GROUP DIRECTION. Oral (live attenuated) Typhoid Vaccine (Ty21a) (Vivotif )
PATIENT GROUP DIRECTION Administration of: Oral (live attenuated) Typhoid Vaccine (Ty21a) (Vivotif ) By: Practice Nurses In: General Practice It is the responsibility of the professional working under
More informationManagement pathway: Treatment of epilepsy in adults
Management pathway: Treatment of epilepsy in adults Key messages Summary of treatment regimens supported by CUHFT/PSHFT consultants to support GP s with prescribing responsibility of antiepileptic drugs.
More informationNEWSLETTER October The Pharmacovigilance Risk Assessment Committee July (PRAC) Meeting
The Pharmacovigilance Risk Assessment Committee (PRAC) Meeting 7-10 July 2014 Finalised safety procedure for methadone products containing povidone Only high molecular weight povidone was associated with
More informationPregnancy and Epilepsy
Pregnancy and Epilepsy Nowhere is the problem more evident or more complicated than in pregnancy. In the United States, epilepsy affects nearly one million women of childbearing potential. Alarm bells
More informationCAMBRIDGESHIRE & PETERBOROUGH STOP SMOKING SERVICE S. Stop Smoking Pharmacological Products Guidance
CAMBRIDGESHIRE & PETERBOROUGH STOP SMOKING SERVICE S Stop Smoking Pharmacological Products Guidance This guidance is for use by Cambridgeshire Stop Smoking Service (CAMQUIT), Peterborough Stop smoking
More informationFactsheet. Buccolam (midazolam) 10mg in 2mL oromucosal solution. Management of seizures in adult patients
North Central London Joint Formulary Committee Factsheet Buccolam (midazolam) 10 mg in 2 ml oromucosal solution Management of seizures in adult patients Start date: May 2017 Review date: May 2020 Document
More informationBeating cervical cancer
Beating cervical cancer The HPV vaccine questions and answers for parents of girls in Year 9 and 10 This Q&A on the HPV vaccine supports the leaflet that your daughter should have been given at school.
More informationJob Title Name Signature Date. Director of Nursing Angela Wallace Signed Angela Wallace 30/6/2014
PATIENT GROUP DIRECTIONS FOR SUPPLY OF VARENICLINE (CHAMPIX ) BY AUTHORISED COMMUNITY PHARMACISTS WORKING IN FORTH VALLEY Protocol Number 445 Version 1 Date protocol prepared: June 2014 Date protocol due
More informationESCA: Cinacalcet (Mimpara )
ESCA: Cinacalcet (Mimpara ) Effective Shared Care Agreement for the Treatment of Primary hyperparathyroidism when parathyroidectomy is contraindicated or not clinically appropriate. Specialist details
More informationMETHYLPHENIDATE AND ATOMOXETINE TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND YOUNG PEOPLE
NOTTINGHAMSHIRE AREA PRESCRIBING COMMITTEE SHARED CARE PROTOCOL AGREEMENT METHYLPHENIDATE AND ATOMOXETINE TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND YOUNG PEOPLE OBJECTIVES To
More informationLow dose depakote side effects
Low dose depakote side effects The Borg System is 100 % Low dose depakote side effects Oct 31, 2014. Studies also show if you take Depakote during pregnancy, your TEEN is at risk for having a lower IQ.
More informationMedicines in Scotland: What s the right treatment for me? Information for patients and the public
Medicines in Scotland: What s the right treatment for me? Information for patients and the public You can read and download this document from our website. We are happy to consider requests for other languages
More informationNHS GG&C Introduction of Freestyle Libre flash glucose monitoring system
NHS GG&C Introduction of Freestyle Libre flash glucose monitoring system The Freestyle Libre flash glucose monitoring system is a sensor based, factory-calibrated system that measures interstitial fluid
More information!This booklet is for family and friends of anyone who.!these decisions may be related to treatment they re
MENTAL CAPACITY ACT INFORMATION What is the Mental Capacity Act? The Mental Capacity Act 2005 (MCA) was implemented by parliament in 2007 and is a vitally important piece of legislation for England and
More informationNational Institute for Health and Clinical Excellence. NICE Quality Standards Consultation attention deficit hyperactivity disorder
National Institute for Health and Clinical Excellence NICE Quality Standards Consultation attention deficit hyperactivity disorder Closing date: 5pm Thursday 21 st March 2013 Organisation Title (e.g. Dr,
More informationConsultation Group: Dr Amalia Mayo, Paediatric Consultant. Review Date: March Uncontrolled when printed. Version 2. Executive Sign-Off
Policy For The Adjustment Of Insulin Injections By Paediatric Diabetes Specialist Nurses/Community Paediatric Nurses Diabetes Working With Children Within NHS Grampian Co-ordinators: Lead Paediatric Diabetes
More informationThe Epilepsy Prescriber s Guide to Antiepileptic Drugs
The Epilepsy Prescriber s Guide to Antiepileptic Drugs The Epilepsy Prescriber s Guide to Antiepileptic Drugs Philip N. Patsalos FRCPath, PhD Professor of Clinical Pharmacology and Consultant Clinical
More informationDocument Details. Ibuprofen 200mg tablets and Ibuprofen oral liquid 100mg in 5ml
Title Document Details Patient Group Direction (PGD) Ibuprofen 200mg tablets and Ibuprofen oral liquid 100mg in 5ml Trust Ref No 1445-36348 Local Ref (optional) Main points the document The treatment of
More informationPROCEDURES AND GUIDANCE
PROCEDURES AND GUIDANCE Working with Substance Misusing Parents and those who come into Regular Contact with Children and Young People Date of original document July 2009 Date document reviewed April 2016
More informationA Framework of Competences for Special Interest Module in Paediatric Epilepsies
A Framework of Competences for Special Interest Module in Paediatric Epilepsies 2 Section 1 CONTENTS Introduction 5 Section 2 Specific Competences in Paediatric Epilepsies 7 Knowledge and Understanding
More informationReflections on NICE Headache Guideline. Dr Kay Kennis GPwSI in Headache, Bradford
Reflections on NICE Headache Guideline Dr Kay Kennis GPwSI in Headache, Bradford Overview The process of guideline development illustrated with the headache guideline Reflections on the process Key recommendations
More informationUse of unlicensed medicines and off-label uses
Use of unlicensed medicines and off-label uses 25 Promoting hope and wellbeing together What is this leaflet about? Your doctor or pharmacist has given you this leaflet because a medicine that you have
More informationDeep brain stimulation for difficultto-treat
Issue date January 2012 Understanding NICE guidance Information for people who use NHS services Deep brain stimulation for difficultto-treat epilepsy NICE interventional procedures guidance advises the
More informationURGENT UPDATED ADVICE ON DOSAGE OF OSELTAMIVIR IN CHILDREN UNDER ONE YEAR OF AGE WITH SWINE FLU
Primary and Community Care Directorate Pharmacy Division T: 0131-244 2518 F: 0131-244 2375 E: bill.scott@scotland.gsi.gov.uk 25 September 2009 abcdefghijklmnopqrstu = 1. Medical Directors NHS Boards 2.
More informationDear Colleagues, NATIONAL STANDARD FOR MONITORING THE PHYSICAL HEALTH OF PEOPLE BEING TREATED WITH LITHIUM
Directorate of Chief Medical Officer T: 0131-244 6930 E: john.mitchell4@gov.scot Dear Colleagues, NATIONAL STANDARD FOR MONITORING THE PHYSICAL HEALTH OF PEOPLE BEING TREATED WITH LITHIUM Lithium is a
More informationEssential Shared Care Agreement: Lithium
Ref No. E042 Essential Shared Care Agreement: Lithium Please complete the following details: Patient s name, address, date of birth Treatment (indication, dose regimen, brand name) Monitoring (proposed
More information